Jun 26 The American Epidemic: Pills and Politics

Opioid overdoses are now the leading cause of accidental death in the United States of America, and a huge portion of the people suffering are middle-age white Americans. Addiction to the drug takes lives, increases crime and strangles households. In the worst of its affects, opioid abuse also has an indelible impact on the country’s children. Hospitals are seeing an increase in newborns addicted to opioids. Children as young as eight are being taught how to administer naloxone, the overdose-reversal drug, in case someone at home is overdosing.

In 2016, 59,000 Americans were killed by the epidemic and according to the surgeon general’s report, only one in ten addicts gets the treatment they need. Among the states with the highest rates of death due to drug overdose are Ohio, New Hampshire and West Virginia. The crisis financially burdens state governments in more ways beside healthcare. Passing a drug test is one of the basic requirements for even minimum wage employment, and when people can’t hold their job because they can’t go without heroin for more than a day, they rely on welfare, and stealing for drugs. The number of abandoned adolescents has sky-rocketed, either because their own parents overdosed, or because addicted parents are unable to provide basic needs for the child, and this in turn strains the foster-care system.

As always, there is no single cause for the issue. In the 1990s, painkillers and pills were heavily marketed and their potential side-effects were relatively unknown. To top that, an employment vacuum was created in the mid-west. For a very long time most jobs were agriculture or factory based, but mechanization and urbanization took these away. Growth was limited to big, coastal cities and the concentrated economic stagnation in rural areas gave birth to the diseases of despair: alcoholism, drug addiction, even suicide. One can blame the prescribing physicians, the pharmaceutical companies, or even the unavoidable psychological pain felt by a stressed population, but it is the solutions that we should focus on.

Ohio has become the face of America’s opioid epidemic, witnessing one of the largest percent increases in drug overdose deaths. Earlier this month, the state filed a lawsuit against five major pharmaceutical companies, claiming that these corporations aided the addiction crisis by misrepresenting the drug risks and by influencing the opinions of doctors. Ohio Attorney General Mike DeWine was the not the first to insinuate these charges and similar cases have been filed and are pending in West Virginia, Mississippi and New York. The precedent lies in the 1990s case against the tobacco industry, which was followed by the largest civil-litigation settlement agreement in U.S. history. Tobacco companies were protected from future suits, but made annual payments to the states to fund anti-smoking campaigns. However, this comparison might be too far-fetched for the current scenario. An important distinction to be made is that opioid-related deaths are caused by the incorrect use of painkillers, something that cannot be said about tobacco and smoking-related deaths.

At the Federal level, the drug related mortality levels have caused some stagnancy in the Senate as they vote on the Affordable Care Act. The expanded Medicaid of the ACA allows Federal or state backed insurance to those low-income adults who were previously not eligible. Phasing out the Medicaid expansion, which is what the House health care bill proposes, could be fatal for many. If the Act is repealed, insurance providers would be allowed to either charge higher premiums or deny coverage for substance-abuse care all together. Key GOP Senators of the concerned states, such as those in Ohio, are reluctant to support this measure as they claim that the lack of affordable treatments would have detrimental effects on their people.

In an unusual bipartisan effort, lawmakers have shown their commitment to the issue by putting together the 21st Century Cures Act. The bill, which was one of President Obama’s last acts, provides funding to the National Institutes of Health and allocates $1 billion to states for the research and treatment of opioid addiction. The NIH is now partnering with drug companies to also develop alternatives to painkillers, ones that cannot cause addiction. President Trump, who addressed addiction during his campaign, was criticized when his proposed budget showed a significant reduction in funding to the Office of National Drug Control Policy. After facing pressure from both Democratic and Republican legislators, the administration reduced the cuts from 95 percent to 5 percent.

Addiction is not like any other illness, and its cure will not be like any other. More than medication, it requires support and supervision. The availability of synthetic opioid drugs is on the rise, and budget cuts as well as the potential replacement of the ACA do not help the matter. The spread of this issue is nation-wide and calls for a collective solution from politicians, regulatory agencies, health institutions and pharmaceutical companies. Preventing addiction rather than dealing with the aftermath will be well advised for our health care systems, justice systems and more importantly, the at-risk households. Coupling this measure with immediate, collaborative intervention across multiple institutions, and we might be fortunate enough to stop the opioid epidemic from spreading to a thousand more lives.